Risk factors for severity of juvenile-onset recurrent respiratory papillomatosis at first endoscopy

The study objective was to determine risk factors for severity of juvenile-onset recurrent respiratory papillomatosis (RRP) at first endoscopic evaluation. Based on a review of all cases undergoing surgery for juvenile-onset RRP in two pediatric otolaryngology departments in the USA and France, the...

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Published in:European annals of otorhinolaryngology, head and neck diseases head and neck diseases, 2019-02, Vol.136 (1), p.25-28
Main Authors: Moreddu, E., Lambert, E., Kacmarynski, D., Nicollas, R., Triglia, J.-M., Smith, R.J.
Format: Article
Language:English
Subjects:
Child
Child, Preschool
Children
Cidofovir
Coinfection - epidemiology
Endoscopy
Female
France - epidemiology
Human papillomavirus
Humans
Iowa - epidemiology
Juvenile-onset papillomatosis
Larynx
Male
Papillomavirus Infections - diagnosis
Papillomavirus Infections - epidemiology
Prognosis
Respiratory Tract Infections - diagnosis
Risk Factors
Severity of Illness Index
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Summary:The study objective was to determine risk factors for severity of juvenile-onset recurrent respiratory papillomatosis (RRP) at first endoscopic evaluation. Based on a review of all cases undergoing surgery for juvenile-onset RRP in two pediatric otolaryngology departments in the USA and France, the following severity risk factors were analyzed: number of laryngeal levels involved, extension to the subglottis, and bilateral involvement. Thirty-two patients were included, with 571 endoscopic procedures. Number of endoscopies per patient varied according to initial extension: 30.67 procedures when all three levels were involved, 15.57 procedures when two and 14.08 procedures when only one (P=0.03). The odds ratio for risk of >14 procedures in 3-level involvement was 20.43 (P=0.047). Initial subglottic extension tended to be associated with more endoscopic procedures (23.67 vs 15.56, P=0.16). RRP severity correlated with initial laryngeal extension of papillomatous lesions at first endoscopy. This finding allowed a short 3-item assessment scale to be created for routine use, complementary to Derkay's assessment scale.
ISSN:1879-7296
1879-730X
DOI:10.1016/j.anorl.2018.11.007